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Additional Credits

I felt honored and privledged to be chosen as one of four recipients of a 2013 fellowship from Management Sciences for Health (MSH) to photograph in Africa. The fellowship was awarded following a global competition organized by Social Documentary.net.

The work wouldn't have been possible without the supervision in Rwanda by MSH manager Marcellin Mugabe, daily guidance on the road of MSH staffer Dr. Moses Ahabwe, and our affable, climb-any-mountain driver, Feliz Nzitatira.

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In northeast Rwanda, community health worker Marie Chantal walks the footpath to her village, Batamuliza Hururiro. Rwanda has three community health workers for each of 14,000 villages. They are coordinated and trained through local health clinics. Marie attends to pregnant woman and mothers with new borns, offering education and support for birth control, breast feeding, and hygenic practices.

Only two decades after horrific genocide, Rwanda has transformed into a peaceful, vibrant country. Among the gains has been remarkable success in improving public health. Since 2005 the country has:

· Halved under-5 child mortality

- Boosted life expectancy to 60 years

- Recorded a 50% increase in hospital and clinic births from 40% to 60% with a corresponding 60% reduction in maternal mortality

- Registered 80% reductions in HIV, TB, and malaria deaths

These gains have corresponed with increased coverage of modern family planning methods from 10% to 45% among currently married women. Policies have also dramatically expanded access to health care with 90% of the population covered under the innovative Community-Based Health Insurance program (Mutuelle). Separately, three community health workers for each of 14,000 villages bring basic education, prevention, and early treatment services for serious diseases like malaria and diarrhea.

For eight days, I documented aspects of rural health care in the northeast and northwest Rwanda, far from the capital, Kigali.

Only two decades after horrific genocide, Rwanda has transformed into a peaceful, vibrant country. Among the gains has been remarkable success in improving public health. Since 2005 the country has:

· Halved under-5 child mortality

- Boosted life expectancy to 60 years

- Recorded a 50% increase in hospital and clinic births from 40% to 60% with a corresponding 60% reduction in maternal mortality

- Registered 80% reductions in HIV, TB, and malaria deaths

These gains have corresponed with increased coverage of modern family planning methods from 10% to 45% among currently married women. Policies have also dramatically expanded access to health care with 90% of the population covered under the innovative Community-Based Health Insurance program (Mutuelle). Separately, three community health workers for each of 14,000 villages bring basic education, prevention, and early treatment services for serious diseases like malaria and diarrhea.

For eight days, I documented aspects of rural health care in the northeast and northwest Rwanda, far from the capital, Kigali.

I felt honored and privledged to be chosen as one of four recipients of a 2013 fellowship from Management Sciences for Health (MSH) to photograph in Africa. The fellowship was awarded following a global competition organized by Social Documentary.net.

The work wouldn't have been possible without the supervision in Rwanda by MSH manager Marcellin Mugabe, daily guidance on the road of MSH staffer Dr. Moses Ahabwe, and our affable, climb-any-mountain driver, Feliz Nzitatira.

In northeast Rwanda, community health worker Marie Chantal walks the footpath to her village, Batamuliza Hururiro. Rwanda has three community health workers for each of 14,000 villages. They are coordinated and trained through local health clinics. Marie attends to pregnant woman and mothers with new borns, offering education and support for birth control, breast feeding, and hygenic practices.

In northeast Rwanda, community health worker Marie Chantal counsels a mother while she nurses her three-week old newborn. She talked to her about good health practices, such as exclusive breast feeding for six months, HIV prevention, and family planning to space children.

A nurse examines a pregnant woman hours before she is scheduled to deliver. The rates of hospital and clinic deliveries in Rwanda have risen markedly due to universal health insurance. Corresponding rates of infant and maternal mortality have fallen markedly.

A mother monitors her newborn in a maternity ward in northwest Rwanda.
Healthcare is improving across Rwanda, with rising rates of births taking place in hospitals and cliniics, wider family planning, and improved maternal health education.

A mother and her new born in a maternity ward in northwest Rwanda. Healthcare is improving across Rwanda, with rising rates of births taking place in hospitals and cliniics, wider family planning, and improved maternal health education.

In rural villages in Rwanda, children appear to be healthy, with marked reductions in under-five mortality rates. This results from an improving economy, wider acces to health care through national insurance, and dramatic reductions in rates of HIV, malaria, and malnutrition.

Community Health Workers receiving training and taking an exam at Rhunda Health Center in eastern Rwanda. The country seeks to have three community workers for each of 14,000 villages - with two specializing in maternal and newborn health, and in under-five health.

A community health worker prepares a three-month birth control inoculation to a patient at Rhunda Health Center in eastern Rwanda. In the room, off-camera, her supervisor observed her methods. The work is part of Rwanda's investment in modern family planning methods that now reach 40% of the population

A community health worker gives a three-month birth control inoculation to a patient at Rhunda Health Center in eastern Rwanda. In the room, off-camera, her supervisor observed her methods. The work is part of Rwanda's investment in modern family planning methods that now reach 40% of the population

Emanuel Bizimungu a community health worker in Rwanda, examines a girl he treated for malaria. She is recovering. They are in Nyagakande village, near the Ruhunda health center in eastern Rwanda. Community health workers are equipped with medication for early treatment of malaria symptoms in communities, without patients needing to travel to hospitals.

Emanuel Bizimungu, a community health worker in Rwanda, examines a boy he treated one month earlier for malaria. The boy recovered a few days after beginning treatment on the drug, Primo. The family lives in Nyagakande village, near the Ruhunda health center in eastern Rwanda. The patient's mother and three siblings look on. Community health workers are equipped with medication for early treatment of malaria symptoms, without patients needing to travel to hospitals.

The Rwandan genocide of only two decades ago remains a powerful memory. These crypts lie at the National Memorial in Kagali, a mass grave for 250,000 victims. Memorials with mass graves are found throughout the countryside.